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Dilation and Curettage (D&C)

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Dilation and curettage (D&C) is a surgical procedure that helps in removing any tissue present in the uterus. The following article will help you know all about D&C and help keep clear any doubts that you may have.

What is Dilation and Curettage (D&C)?

The surgical procedure where the cervix is dilated and a thin instrument (curette) is inserted into the uterus is called dilation and curettage. The curette helps in scrapping any tissue present inside the uterus (curettage). Sometimes, the doctors refer to the procedure as dilatation and curettage.

Why is a D&C Done?

D&C is carried out for many reasons that include:

  • For women suffering from menstrual bleeding like menorrhagia or abnormal bleeding between periods
  • To remove polyps between the mucous membrane of the uterus
  • To clean the uterus after a miscarriage
  • To get a tissue sample of the uterus for endometrial biopsy to check for cancer
  • To induce abortions before the 12th week of pregnancy

How Does One Prepare for D&C?

D&C can be done in a doctors clinic, outpatient clinic or even at the hospital. The procedure takes about 10 to 15 minutes only. However, after the procedure, the patient will be required to stay back for at least 5 hours.

Before the procedure is carried out, one will have to sign a consent form. Complete medical history will be asked of the patient. It is very important to inform beforehand, in case :

  • One suspects they are pregnant
  • Have an allergic reaction to any medication, latex or iodine
  • Have a bleeding disorder

In this procedure, one is put under anesthesia. The type of anesthesia depends on the cause of the procedure. One will be given a spinal or epidural, local or general anesthesia.

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In some cases, the doctor may use Laminaria. This is a slender rod made of synthetic or natural materials. It is inserted into the cervix to help it dilate before the surgery. This laminaria is kept in place for several hours. The rod stretches by taking in fluids from the cervix. Thus, expanding the cervical opening.  Some may be given certain medications to help dilate the cervix easily.

What Happens During the Procedure?

During the procedure, you will be given a gown to wear. The nurse may ask you to go an empty your bladder. Then, you will be asked to sleep on a table with your legs in stirrups. Now, a speculum will be placed in the vagina and a number of rods will be inserted into the cervix. This will help dilating the cervix to about one half and a half in diameter.

Once this is done, the tissue lining the uterus is removed with the help of an instrument called curette or with suction. The tissue removed will be sent to the lab for further analysis. All this will be done under local, general or spinal anesthesia. If one is given local anesthesia, they may experience cramping when the tissues are scrapped from the uterus.

What Happens after D&C?

After the procedure you will be taken to the recovery room. The blood pressure, heart rate, blood oxygen levels will all be measured. You will be asked to wear a sanitary pad for bleeding. The doctor will ask you to rest for about 2 to 5 hours. One may even experience cramping as well as light bleeding or spotting for a few days after the procedure. Do not carry our strenuous activity for a few days. Do not use tampons or have intercourse for two or three days.

The doctor may advice  pain killers to ease the cramping. Make sure you call the doctor immediately if you suffer from heavy bleeding, fever, chills, smelly vaginal discharge or severe abdominal cramps. Follow the doctor's advice carefully. While going home, make sure you have a friend or family member to drive you home. This is because you will still be suffering from the after effects of the anesthesia.

After the dilation and curettage, the uterus will grow back a new lining. This will affect the date of your regular menses. They may come sooner or later than normal. Also, make sure you do not insert anything into your vagina for a couple of days after the procedure. This is because the cervix will take time to get back to its normal size. This can allow bacteria to enter the uterus and cause an infection. For any more information, speak to your obstetrician or gynecologist.

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Written by: Saptakee sengupta
Date last updated: March 13, 2015